What Is Acute Prostatitis?

Acute prostatitis is the sudden onset of inflammation in the prostate. The prostate gland is a small, walnut-shaped organ located at the base of the bladder, in front of the rectum. The prostate provides 70 percent of the fluid for ejaculation. Contraction of the prostate during ejaculation prevents semen from flowing backward into the bladder.

Acute prostatitis is usually caused by the same bacteria that result in urinary tract infections and sexually transmitted diseases (STDs). Bacteria can travel to the prostate from the blood, or enter the prostate during or after a procedure such as a biopsy. It can also be caused by infections in other parts of the male genitourinary tract.

epididymitis (inflammation of the epididymis, the tube that connects the testicles and the vas deferens)

urethritis (inflammation of the urethra)

injury to the perineum (the area between the scrotum and the rectum)

urinary catheters or cystoscopy

inability to pull back the foreskin of the penis (phimosis)

bladder outlet obstruction (can occur with an enlarged prostate or stones in the bladder)

Who Is at Risk for Acute Prostatitis?

Factors that increase the risk for conditions such as UTIs, STDs, and urethritis also increase the risk for acute prostatitis. Men who have multiple sexual partners or anal intercourse without condoms are at greater risk, too.

Other risk factors include:

age (men over the age of 50 are more likely to have enlarged prostate glands, which predisposes them to UTIs)

past episode(s) of prostatitis

HIV/AIDS

psychological stress

dehydration (not drinking enough fluids)

certain genes can predispose someone to the development of prostatitis

pelvic injuries from bike or horseback riding

orchitis (inflammation of the testicles)

What are the Symptoms of Acute Prostatitis?

The symptoms of acute prostatitis are:

chills

fever

pelvic pain

blood in the urine

urinary frequency

painful urination

foul-smelling urine

decreased urinary stream

difficulty emptying the bladder

difficulty when starting to urinate

painful ejaculation

blood in the semen

discomfort with bowel movements

pain above the pubic bone

pain in the genitals, rectum, or testicles

How Is Acute Prostatitis Diagnosed?

Diagnosis of acute prostatitis begins with your medical history and a physical examination. Doctors will do a digital rectal examination (DRE) using a gloved, lubricated finger. The prostate is in front of the rectum, so it can be easily felt. In acute bacterial prostatitis, the prostate is usually swollen and tender.

During the DRE, the doctor may massage the prostate to force a small amount of fluid into the urethra. The fluid can be examined for signs of infection

In addition, groin lymph nodes may be enlarged and tender. There may be fluid coming from the urethra (urethral discharge). Additional tests include:

urinalysis to test for blood, white cells, or bacteria

urine culture to identify the cause of a UTI

blood culture to rule out bacteria in the blood

urethral swab to test for gonorrhea and/ or chlamydia

cystoscopy to look at the bladder and urethra to see if they are the source of the infection.A cystoscope is a small instrument, with a camera attached.

urodynamic tests to evaluate if there is a problem with emptying the bladder

How Is Acute Prostatitis Treated?

Acute bacteria prostatitis is treated with antibiotics for four to six weeks. The treatment may last longer if you are having recurrent episodes. The type of antibiotic depends on the bacteria causing your prostatitis. To relieve your symptoms, your doctor may prescribe alpha-blockers. These drugs relax bladder muscles and decrease urinary discomfort. Examples of alpha-blockers include doxazosin, terazosin, and tamsulosin. Pain relievers such as acetaminophen and ibuprofen may help with discomfort, too.

Other treatments such as heat treatment using a microwave device, and medications from certain plant extracts are also being evaluated.